Which condition involves rotation of the ovary causing obstruction of blood vessels?

• A. Ovarian torsion
• B. PID
• C. Priapism
• D. Pyelonephritis

Answer: (A)

Ovarian torsion occurs when the ovary twists around its vascular pedicle, twisting the blood vessels that supply the ovary. This first blocks venous outflow, causing edema, and if the twisting continues, arterial inflow is compromised, leading to ischemia and potential ovarian necrosis if not detorsed promptly. The result is a sudden, severe unilateral pelvic pain often with nausea or vomiting. On exam you may find adnexal tenderness or a palpable mass; imaging with Doppler can show reduced or absent blood flow, though flow may be preserved early in some cases. Because it’s a surgical emergency, prompt detorsion is needed to try to salvage the ovary; if the ovary is nonviable, removal may be necessary. This is distinct from PID, which is an infectious process typically presenting with bilateral lower abdominal pain, fever, and cervical motion tenderness, not due to twisting of the ovary.